The Republican ObamaCare Choke

Less than three months into full control of government and the chance to reshape the American system for a generation, Republicans are doing something no one thought possible: They are reinventing the circular firing squad.

Even a politician of such limitless cynicism as Chuck Schumer is agog: “We are on offense and united. They are on defense and divided, the opposite of what people would have predicted a month or two ago.”

Maybe in politics, genes really are destiny. Under pressure from a CBO “score,” the genetic disposition of Republican politicians is to go wobbly. The disposition of movement conservatives is to get out the long knives and start carving up other conservatives.

The result will be guaranteed political defeat for years if congressional Republicans choke at the chance to repeal and replace ObamaCare.

The Beltway bubble has never looked so big or real as now, to wit: The Trump-Ryan-Price health-care reform bill is too tough on Medicaid. Or it isn’t tough enough. It will break the Trump entitlement bond with the middle class. We want the 2015 repeal-only bill. Let ObamaCare collapse. What’s the rush? We can do this reform some other time.

The American people didn’t endure and survive the 2016 presidential election for this. The public that voted Donald Trump into the White House will drive Republicans into a deserved wilderness if they go back on theonlypromise anyone can remember them making the past six years.

The day the Republicans clutch on this reform, there will be six-column headlines across the Washington Post andNew York Times: “Trump Abandons Promises on Health Care.”

It will be a fast ride downhill from there. That is because the health-care reform bill is linked inextricably to the politics of tax reform, the second pillar of the Trump legislative agenda.

The CBO score gifted the Republicans with $1 trillion in savings over a decade from the adjusted spending baseline, a number that would carry forward into the score for the tax bill, enabling the lower tax rates on income and capital that will lift the economy. (Remember that promise?)

The cruder political point is that if health-care reform fails under media-driven Beltway pressure, the same timid people will next block the historic tax-reform bill with the same tactics. They will peck it to death with misgivings. Political courage used to have a postelection shelf life of about 12 months. Now it has the life cycle of a moth.

The logic is inescapable of what will happen if reform of both health care and taxes goes out with a whimper. As President Trump’s political capital and approval decline under a barrage of media-payback glee, and as the clock moves closer to the midterm election, Republicans will head for the tall weeds on everything. The Trump presidency will be over in under a year.

The conservative “friends” counseling Mr. Trump to give up now on health-care reform will move overnight to the next darling, say, Sen.Mike Leewho wrote on the Heritage Foundation’s blog Monday that Republicans should vote for repeal only and “take our time” on reform.

In the wake of repeal only, the U.S. health insurance market would be reduced to a shambles. After that, the next major party will be the Libertarians, because the GOP will be defunct. Maybe that’s what cable-TV starRand Paulis up to.

An important separation may be occurring with this bill. On one side you have the status quo. It’s not just the American Medical Association and others who created the ObamaCare that failed and want its replacement to fail. The status quo is also the activist groups and pundits whose status and power are tied to keeping their opinions first and all else second.

Across from this status quo that is the one real thing that drove the 2016 election: the voting public’s desire for change. The 2016 election seemed like a radical upheaval, but it was mainly a cry for a restoration.

That means restoring the balance of power between the branches of government that was undone byBarack Obama.When some members of Congress say they “won’t vote” for the health-care bill, what they are saying is: “Let’s negotiate. I want something for my vote.” Mr. Trump’s personal willingness to do business with his opposition restores this normal reality to American politics.

The election was also about resetting the balance of authority between Washington and the states—a key goal of this reform’s Medicaid provisions. The Democrats are united in opposition because they’ve become a rule-from-Washington party. But the Republicans?

If this bill fails, there is only one Plan B. It will be a single-payer system enacted after 2020 with votes from what’s left of the Republican party after—Donald Trump is right about this—they get wiped out in 2018 and lose the presidency two years later. After blowing it on ObamaCare, why would anyone vote for them again?